Yuto Hamada, Dennis Thomas, Vanessa M McDonald, Erin S Harvey, Michael Fricker, Andrew Gillman, Mark Hew, Vicky Kritikos, John W Upham, Peter G Gibson
{"title":"Impact of clinical remission on quality of life in severe eosinophilic asthma treated with mepolizumab.","authors":"Yuto Hamada, Dennis Thomas, Vanessa M McDonald, Erin S Harvey, Michael Fricker, Andrew Gillman, Mark Hew, Vicky Kritikos, John W Upham, Peter G Gibson","doi":"10.1016/j.anai.2025.06.017","DOIUrl":"10.1016/j.anai.2025.06.017","url":null,"abstract":"<p><strong>Background: </strong>Biologics can induce clinical remission in severe asthma. However, the benefits of achieving remission from the patient's perspective remain unclear.</p><p><strong>Objective: </strong>To assess the association between achieving clinical remission and health-related quality of life (HRQoL) in patients with severe eosinophilic asthma treated with mepolizumab.</p><p><strong>Methods: </strong>In this nested, matched case-control study, data from the Australian Mepolizumab Registry (AMR) were used to compare the proportions of participants attaining Asthma Quality of Life Questionnaire (AQLQ[S]) scores of greater than or equal to 6, indicating minimal or no HRQoL impairment, between 42 participants who achieved clinical remission at 12 months and 64 propensity score-matched participants who did not. Assessed AQLQ(S) scores included overall and domain scores for symptoms, activity limitation, emotional function, and environmental stimuli. Clinical remission was assessed at 12 months, defined as Asthma Control Questionnaire-5 score less than 1.5, no exacerbations in the previous 12 months, and no oral corticosteroids use for asthma.</p><p><strong>Results: </strong>A greater proportion of participants achieving clinical remission had AQLQ(S) scores of greater than or equal to 6 at 12 months compared with those who did not: overall scores (61.9% vs 26.6%, P = .001), symptom domain (59.5% vs 29.7%, P = .004), activity limitation domain (59.5% vs 28.1%, P = .003), emotional function domain (69.0% vs 31.2%, P < .001), and environmental stimuli domain (57.1% vs 34.4%, P = .035).</p><p><strong>Conclusion: </strong>Achieving clinical remission at 12 months was associated with minimal or no impairment in HRQoL, although approximately 38% of participants in remission still experienced impaired HRQoL, highlighting residual unmet needs. Further research is needed to better understand the benefits of asthma remission from the patient's perspective.</p><p><strong>Clinical trial registration: </strong>The AMR is registered in the Australian New Zealand Clinical Trials Registry (ACTRN12618001497291). The AMR is a nationwide, multicenter, prospective, observational registry for the postmarketing surveillance of mepolizumab in severe eosinophilic asthma. The AMR is approved by the Human Research Ethics Committees in the study sites, and all participants provided written informed consent before enrollment.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claire Hopkins, Larry Borish, Jared Silver, Peter Howarth, Robert Chan, Priya Dsilva, Joseph K Han
{"title":"Categorizing clinical response to mepolizumab for patients with chronic rhinosinusitis with nasal polyps: SYNAPSE trial.","authors":"Claire Hopkins, Larry Borish, Jared Silver, Peter Howarth, Robert Chan, Priya Dsilva, Joseph K Han","doi":"10.1016/j.anai.2025.06.018","DOIUrl":"10.1016/j.anai.2025.06.018","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel G Rayner, Layla Bakaa, Flavia Hoyte, Tamara T Perry, Katherine Rivera-Spoljaric, Kaharu Sumino, Bradley Chipps, John Oppenheimer, Sharmilee M Nyenhuis, Elliot Israel, Ellen McCabe, Paul M O'Byrne, Lindsay E Shade, Valerie G Press, Gordon H Guyatt, Susana Rangel, Dia Sue-Wah-Sing, Lisa Hall, Hilarry Orr, Angel Melendez, Tonya Winders, Donna D Gardner, Kathyrn Przywara, Matthew A Rank, Leonard B Bacharier, Giselle Mosnaim, Derek K Chu
{"title":"Triple therapy vs dual inhaler therapy for moderate-to-severe asthma: An updated systematic review and meta-analysis.","authors":"Daniel G Rayner, Layla Bakaa, Flavia Hoyte, Tamara T Perry, Katherine Rivera-Spoljaric, Kaharu Sumino, Bradley Chipps, John Oppenheimer, Sharmilee M Nyenhuis, Elliot Israel, Ellen McCabe, Paul M O'Byrne, Lindsay E Shade, Valerie G Press, Gordon H Guyatt, Susana Rangel, Dia Sue-Wah-Sing, Lisa Hall, Hilarry Orr, Angel Melendez, Tonya Winders, Donna D Gardner, Kathyrn Przywara, Matthew A Rank, Leonard B Bacharier, Giselle Mosnaim, Derek K Chu","doi":"10.1016/j.anai.2025.06.011","DOIUrl":"10.1016/j.anai.2025.06.011","url":null,"abstract":"<p><strong>Background: </strong>Long-acting muscarinic antagonists are typically added to inhaled corticosteroids (ICS) and long-acting β-agonists (LABA) for asthma management.</p><p><strong>Objective: </strong>To systematically synthesize the benefits and harms of triple therapy (ICS/LABA/long-acting muscarinic antagonists) compared with dual therapy (ICS/LABA) for asthma management across key subpopulations as part of developing linked American Academy of Allergy, Asthma, and Immunology/American College of Allergy, Asthma, and Immunology guidelines.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, the Cochrane Controlled Register of Trials, and the International Clinical Trials Registry Platform from January 1, 2020 to February 1, 2025, for randomized trials comparing inhaled triple therapy to dual therapy for asthma to update our previous systematic review. Paired reviewers independently screened citations, extracted data, and assessed the risk of bias. Random effects meta-analyses assessed asthma control (asthma control questionnaire-7; 0-6), asthma-related quality of life (asthma quality of life questionnaire; 1-7), prebronchodilator forced expiratory volume in 1 second, severe exacerbations, and serious adverse events. The Grading of Recommendations, Assessment, Development, and Evaluation approach informed the certainty of evidence. Open Science Framework Registration (https://osf.io/u8t4q/).</p><p><strong>Results: </strong>A total of 26 trials randomized 12,431 participants. Compared with dual therapy, triple therapy reduces severe exacerbations in patients at high risk for future exacerbation (relative risk 0.83, 95% CI 0.76-0.90; risk difference 5.3% fewer; high certainty), with trivial improvement in asthma control (mean difference [MD] -0.04, 95% CI -0.07 to 0.00, moderate certainty; lower better), quality of life (MD 0.05, 95% CI -0.03 to 0.14, moderate certainty; higher better), and prebronchodilator forced expiratory volume in 1 second (MD 0.07, 95% CI 0.05-0.09; high certainty), without increase in serious adverse events (moderate certainty). The effects were consistent across age, body mass index, and exacerbation history.</p><p><strong>Conclusion: </strong>In patients with moderate-to-severe asthma, triple therapy, compared with dual therapy, reduces severe exacerbations in patients at high risk for future exacerbation with minimal harm.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pranav M Bajaj, Madeleine Kanaley, Samantha Sansweet, Kethan Bajaj, Julia Auerbach, Eirene Fithian, Khalid Ibrahim, Ruchi Gupta
{"title":"Determining avenues for improved food allergy support and safety on college campuses.","authors":"Pranav M Bajaj, Madeleine Kanaley, Samantha Sansweet, Kethan Bajaj, Julia Auerbach, Eirene Fithian, Khalid Ibrahim, Ruchi Gupta","doi":"10.1016/j.anai.2025.06.005","DOIUrl":"10.1016/j.anai.2025.06.005","url":null,"abstract":"<p><strong>Background: </strong>Food Allergy (FA) is a chronic disease with public health importance affecting an estimated 1 in 13 children and 1 in 10 adults. Limited research is available on policies and support available at the college level.</p><p><strong>Objective: </strong>To better understand the experiences of college students with and without FA to determine avenues to improve safety and quality of life for college students with FA.</p><p><strong>Methods: </strong>An online, cross-sectional survey was distributed to college students with and without FA in the United States from 2021 to 2023. Descriptive statistics were used to determine respondent demographics, FA knowledge, student reaction history, effects of FA on social life, and recommendations for improvement of FA safety and awareness on campus.</p><p><strong>Results: </strong>A total of 204 students-78 with FA-completed the survey from 72 US universities. Of the students with FA, 41% reported that their university was not aware of their FA and 28% experienced a food allergic reaction in their campus dining hall, with the most common cause being food mislabeled with allergen (43%). Students with FA mostly endorsed wanting regular FA training for campus dining staff (71%) and increased availability of stock epinephrine in the dining halls (59%) to improve safety on campus.</p><p><strong>Conclusion: </strong>To ensure the safety of students with FA and reduce reactions on campus, it is imperative that universities improve the identification of students with FA, increase regular FA training for dining staff, and increase the availability of stock epinephrine in dining halls.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Shahzad Mustafa, Anthony Ocon, Karthik Vadamalai, Allison Ramsey
{"title":"Management of eosinophilic granulomatosis with polyangiitis-associated sinusitis with dual biologics: Anti-interleukin-5/interleukin-5 receptor plus anti-interleukin-4/interleukin-13.","authors":"S Shahzad Mustafa, Anthony Ocon, Karthik Vadamalai, Allison Ramsey","doi":"10.1016/j.anai.2025.06.010","DOIUrl":"10.1016/j.anai.2025.06.010","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vaccine hesitancy for allergist-immunologists.","authors":"Charlotte A Moser","doi":"10.1016/j.anai.2025.06.009","DOIUrl":"10.1016/j.anai.2025.06.009","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Paula Henao, Joshua Malerich, Daniel R George
{"title":"Impact of language barriers on pulmonary function and asthma control.","authors":"Maria Paula Henao, Joshua Malerich, Daniel R George","doi":"10.1016/j.anai.2025.06.003","DOIUrl":"10.1016/j.anai.2025.06.003","url":null,"abstract":"<p><strong>Background: </strong>Asthma disproportionately affects non-English-speaking populations, with language barriers contributing to worse health outcomes, including increased emergency department (ED) visits and hospitalizations. Addressing these disparities requires culturally and linguistically appropriate care.</p><p><strong>Objective: </strong>To evaluate the impact of language barriers on asthma control and pulmonary function testing.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed data from 28,346 patients aged 12 years and older with asthma. Patients were categorized as English- or non-English-speaking on the basis of language preference in electronic health records. Asthma outcomes were measured using the asthma control test (ACT), pulmonary function tests, and health care utilization patterns (outpatient visits, ED visits, and hospitalizations). Atopy was assessed using skin prick tests or specific IgE when available.</p><p><strong>Results: </strong>English-speaking patients were more likely to have ACT scores (odds ratio [OR] 1.43, 95% CI 1.11-1.83) and pulmonary function tests (OR 1.75, 95% CI 1.31-2.31) recorded in their health records. Non-English-speaking patients were more likely to have uncontrolled asthma (ACT ≤ 20, OR 4.3, 95% CI 2.61-7.09) and lower forced expiratory volume in 1 second percent predicted (mean = 70.7 vs 78.4, P = .007). Non-English speakers were less likely to have ambulatory visits (OR 2.00, 95% CI 1.56-2.57) but more likely to seek care in EDs (OR 1.36, 95% CI 1.17-1.58). Hospitalization rates were similar between groups. Atopy prevalence was similar.</p><p><strong>Conclusion: </strong>Language barriers significantly impact asthma management, leading to worse outcomes in patients with limited English proficiency. Health systems should prioritize professional interpreters, bilingual education, and technological solutions (eg, artificial intelligence-based translation models) to reduce disparities. Future research should assess the long-term effects of language-concordant interventions.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Henriette Farkas, Jonny G Peter, Marcin Stobiecki, John Anderson, Emel Aygören-Pürsün, David Hagin, Miloš Jeseňák, Aharon Kessel, Sorena Kiani-Alikhan, Tamar Kinaciyan, Michael Manning, Avner Reshef, Adrian Wu, Heather A Iocca, Douglas T Johnston, Lindsey Noble, Dianne Tomita, Aleena Banerji
{"title":"Long-term safety and efficacy of once-daily berotralstat in patients with hereditary angioedema: APeX-S final results.","authors":"Henriette Farkas, Jonny G Peter, Marcin Stobiecki, John Anderson, Emel Aygören-Pürsün, David Hagin, Miloš Jeseňák, Aharon Kessel, Sorena Kiani-Alikhan, Tamar Kinaciyan, Michael Manning, Avner Reshef, Adrian Wu, Heather A Iocca, Douglas T Johnston, Lindsey Noble, Dianne Tomita, Aleena Banerji","doi":"10.1016/j.anai.2025.06.004","DOIUrl":"10.1016/j.anai.2025.06.004","url":null,"abstract":"<p><strong>Background: </strong>Berotralstat is a once-daily oral medication for the prophylaxis of hereditary angioedema (HAE) attacks in patients aged 12 years and older.</p><p><strong>Objective: </strong>To assess the long-term safety and efficacy of berotralstat in patients with HAE caused by C1 inhibitor deficiency.</p><p><strong>Methods: </strong>APeX-S was a global, open-label phase 2 study (NCT03472040) assessing berotralstat 150 and 110 mg for up to 96 weeks in the United States and 240 weeks elsewhere. The primary objective was long-term safety and tolerability; secondary objectives included efficacy and impact on quality of life (QoL) of berotralstat. Safety was evaluated by means of treatment-emergent adverse events and laboratory analyses. Efficacy was assessed using the number and rate of HAE attacks, durability of response, and number and proportion of days with angioedema symptoms. QoL was evaluated using the Angioedema Quality of Life Questionnaire.</p><p><strong>Results: </strong>In APeX-S, 387 patients were enrolled and received berotralstat 150 mg (n = 287) or 110 mg (n = 100) from day 1. A total of 70 patients on berotralstat 110 mg crossed over to berotralstat 150 mg after a median (range) of 48 (46-71) weeks. Treatment-emergent adverse events up to 240 weeks were reported by 334 patients (86.3%); the most common being nasopharyngitis (23.8%), headache (14.7%), diarrhea (14.5%), upper respiratory tract infection (12.9%), and abdominal pain (11.1%). Treatment with berotralstat led to improvements in HAE attack rates and Angioedema Quality of Life Questionnaire scores up to week 96, with greater improvements observed in patients who received berotralstat 150 mg from day 1.</p><p><strong>Conclusion: </strong>This study supports the long-term safety of berotralstat and its efficacy in preventing HAE attacks and improving QoL.</p><p><strong>Clinical trial registration: </strong>This trial was registered at ClinicalTrials.gov as NCT03472040 (https://clinicaltrials.gov/study/NCT03472040).</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}